Is there any wriggle room on over-70 medical card income limits?

I was 70 this month and, when checking the HSE site, I saw that there is a cut off joint income for both Medical Card and GP Card since 2015.

On a gross, our income would be about €100 over the limit. However, as are both paying tax and PRSI, our net income would be less.

I cannot recall hearing any announcement from the Department on this and was wondering if it is still the case?

Ms S.C., email

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Health bills can be a significant issue for us as we age. And that is why, for a long time, older people – those over the age of 70 – got a free medical card.

A card entitles you to free visits to see your GP and also free access to public hospital outpatient and inpatient services. In addition, you do not have to pay for any medicines prescribed for you – although you will still be liable for the €1 per prescription charge (up to a maximum of €10 a month). That figure is higher for younger card holders but we will stick with the rules for those over 70 here.

Finally, you can get free eye, ear and dental checks with your card.

But, as you say, that automatic entitlement to a medical card ended in 2015. Since then everyone has to undergo a means test to see if they qualify for a card. The test for people over the age of 70 is significantly more generous than for younger people but it is still a hurdle for some.

And no, there has been no change since to those rules.

You say that your gross income is around €100 over the threshold for a married couple over the age of 70, which is €1,050 a week. I’m not sure if you are looking just at income from cash sources, such as a pension, but you need to be aware that the means test will also consider the income that any investments you have would yield.

The bad news from your position is that there is no allowance for exemptions – such as tax and PRSI payments. The €1,050 relates to weekly gross income for a couple where at least one member is over the age of 70. The limit for a single person is €550 a week.

So what happens if you are over this limit? It depends. You can choose to be assessed under normal medical card rules that apply for younger applicants. This excludes things like mortgage payments or rent and, for some, might make a difference.

More importantly, the general rules allow for an exemption where the means test rules would result in financial hardship. This is normally a claim that can be made where one of you has significant ongoing medical bills.

If none of that applies, then you are left with the option of applying for a GP card. If you are over 70, you automatically qualify for a GP Visit card regardless of income.

However, unless they too are over 70 years of age, your husband or civil partner might not be eligible for the card. For dependents under the age of 70 to qualify, the family income needs to be no more than €1,400 a week.

This will cover most costs incurred in visiting your GP, including blood tests. But you will face charges for certain things – including visits for the purpose of renewing a driving licence.

Lack of a medical card also means you will be liable for the cost of medicines – up to a maximum of €114 every month.

Please send your queries to Dominic Coyle, Q&A, The Irish Times, 24-28 Tara Street, Dublin 2, or email dcoyle@irishtimes.com. This column is a reader service and is not intended to replace professional advice. No personal correspondence will be entered into